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Obligate intracellular parasites are unable to reproduce outside a host cell; most have lost the ability to synthesize substances needed for extracellular growth. Species of Rickettsia, Orientia, and Ehrlichia are tiny Gramnegative rods that are spread when a blood-sucking arthropod transfers bacteria during a blood meal. Coxiella burnetii is a Gram-negative rod that survives well outside the host due to the production of sporelike structures. (Figure 11.29)

Chlamydia species are transmitted directly from person to person. (Figure 11.30)

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